Join Our Team Full Name * Phone Number * Email Address *Please leave this field empty. City * State * ZIP Code * Position Applying For *Registered Nurse (RN)Licensed Practical Nurse (LPN)Certified Nursing Assistant (CNA) Current Status *Active and in good standingNot active / needs review License/Certification Number * State of License/Certification * Expiration Date * Available Start Date License/Certification TypeRN LicenseLPN LicenseCNA Certification / RegistryOther Other License/Certification Type Current or Most Recent Employer Position / Title Years of Experience *Less than 1 year1–3 years3–5 years5+ years Preferred Work Type — select all that applyFull TimePart TimePRN / FlexibleTemporary / Contract Facility Experience — select all that applySkilled Nursing Facility / Nursing HomeHospitalAssisted LivingRehabilitation CenterMemory CareHome Care / Home HealthHospiceLong-Term CareOther Other Facility Experience Current Certifications — select all that applyCPRBLSFirst AidDementia Care TrainingAlzheimer’s Care TrainingMedication Administration TrainingOther Other Certification Preferred Shift(s) — select all that applyDay ShiftEvening ShiftNight ShiftWeekdaysWeekends Please Answer the Following Are you legally authorized to work in the United States? *YesNo Are you willing to complete required background screening? *YesNo Are you willing to complete required drug screening when applicable? *YesNo Are you able to provide documentation supporting listed licenses, certifications, and qualifications? *YesNo Upload Documents Resume Professional License / CNA Certification CPR/BLS Certification Additional Certifications or Training Documents Other Supporting Documents Applicant Certification I certify that the information provided in this application is accurate and complete to the best of my knowledge. I understand that ElandCare may verify information provided as part of its recruitment, credentialing, and employment processes. *
